• Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist I (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances ... achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances Specialist I...requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical situations… more
    LA Care Health Plan (11/06/25)
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  • Customer Solution Center Appeals

    LA Care Health Plan (Los Angeles, CA)
    Customer Solution Center Appeals and Grievances Specialist II (Temporary) Job Category: Customer Service Department: CSC Appeals & Grievances ... safety net required to achieve that purpose. Job Summary The Customer Solution Center Appeals and Grievances (A&G) Specialist II will receive, investigate… more
    LA Care Health Plan (11/06/25)
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  • Senior RN Peer Review Specialist

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …healthcare? Bring your true colors to blue. The Role:The Peer Review Specialist is responsible for monitoring the quality of the credentialed practitioner/ ... Credentialing & Peer Review (CPR) Team, the Peer Review Specialist works closely with CPR's Director and Clinical Lead,...subscriber certificates and apply to the investigation of member grievances . + Manage the fair hearing process for cases… more
    Blue Cross Blue Shield of Massachusetts (12/25/25)
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  • Provider Contracting Senior Analyst - Cigna…

    The Cigna Group (Salem, OR)
    …Complete onsite quality assessments + Respond to provider inquiries, concerns, complaints, appeals and grievances + Provide ongoing product education to dentists ... procedures to routine instructions that require professional knowledge in specialist areas. Provides standard professional advice and creates initial… more
    The Cigna Group (12/12/25)
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